Letter of thanks to Tanoa from the National Child Cancer Network

Dear Mr Krishna

RE: Visit to Samoa 22-25 April 2018,by members of the NZ National Child Cancer Network (NCCN) Pacific working group

On behalf of my colleagues Dr Peter Bradbeer, Janet Masina, Taneel Sharma and Bridget Smith, thank you to Tanoa Hotels for providing complimentary accommodation for Peter, Janet, Taneel and Bridget for the duration of our visit. I stayed with Family in Apia.
They reported being made most welcome by your amazing Tanoa staff and enjoyed the relaxing environment that the Tanoa provides.
Our working group receives no financial support from our institution/s, and members take annual leave for the visit. We have been fortunate to receive funding from a small NZ based charity- World Child Cancer Charitable Trust- to cover other costs such as airfares and transfers.
Our team has been visiting Samoa annually since 2006.

Purpose of Visit Samoa 23-25 April 2018:
1. To review children with cancer on chemotherapy.
2. To review children with cancer who have completed their chemotherapy.
3. To consult on paediatric patients with a potential malignancy or haematological problem as identified by the paediatric or surgical staff at TTM Hospital.
4. To meet with Dr Tito Kamu- Head of Paediatrics and Dr Litara Esera.
5. To identify barriers to diagnosing, referring and treating children with cancer.
6. To review the case notes of children with a potential cancer referred who never reached Starship
7. To continue to work with the Paediatric team (medical, including surgery, nursing, laboratory, radiology) on “caring for the children with cancer” – from early identification and referral to NZ if criteria met (ie: triaged as a good risk cancer as per the Pacific Child Cancer guidelines), completion of chemotherapy at TTM and palliative care for those children, not deemed to have a good risk cancer.
8. To provide training to the 2 nurses-newly identified – on the safe preparation and administration of chemotherapy.
9. To continue to work with the Paediatric team (medical, nursing, pharmacy) around continuity of supply of chemotherapy drugs, teaching on the storage, safe preparation, administration of chemotherapy, and disposal of cytotoxic waste.
10. To meet with laboratory staff – re progress, in Haematology, since our previous visit.
11. Teaching to paediatric nursing, junior medical staff, medical students as requested.
12. To continue to work with the Samoa Cancer Society around the promotion of the early warning signs, and care and support for children with cancer and their families in Samoa, and when they come to NZ.
13. Provide palliative care support to Samoa Cancer Society and review any pediatric patients as requested.

Proposed outcomes:
 To improve the outcomes of children and adolescents with cancer in Samoa, by working in partnership with the Ministry of Health/NHS (Samoa), clinical services (TTM Hospital) for children and adolescents, and their families (Samoa Cancer Society).
 Enhanced relationship with Ministry of Health/NHS and understanding of the process of the Overseas referral scheme
 Safe and timely delivery of chemotherapy for children returning from Starship to Samoa
 Continued relationship with the Samoa Cancer Society
 Continue to raise awareness that children with cancer in Samoa do not all have to die untreated, and early detection and referral important
We were able to address all we set out to and were impressed at the engagement and the progress made by the Samoan Pediatric Health professionals who are caring for the children with cancer.On a population basis 10-11 new cases of childhood cancer would be expected each year in Samoa. In the last 12 months we have seen an increase in diagnoses and timely referral out of country when indicated.
Prior to 2006 all children with cancer in Samoa died.We reviewed 2 children who are on chemotherapy and 5 children who have completed their cancer treatment- they are well and back at school.The Samoa Cancer Society has been key to ensuring engagement with these families, facilitating transport to hospital visits for treatment and providing ongoing support when needed.